Intactivism News

October - December 2007

Mohels Give Non-Jewish Babies a Slice of Tradition

By John MacDonald

When his son was born, Reverend Louis DeCaro Jr. was dismayed to learn that none of the doctors on call at Manhattan’s Allen Pavilion hospital had time to perform the circumcision. [That's what they said. Or are they starting to have ethical qualms?] At a loss, the DeCaros turned for advice to their Manhattan pediatrician, Andrew Mutnick, who offered a simple solution: Hire a Jewish ritual circumciser, known as a mohel.

...

“When [a circumcision] is done by a mohel, you appreciate the gravity, the beauty of the religious connotations,” DeCaro said in an interview with the Forward. ["You" may - the baby certainly doesn't.]

... Sherman, 51, may be one of the most prolific circumcisers in the tri-state area, ["prolific" means you abundantly create something....] but others — including Emily Blake in New York and Joel Shoulson in Philadelphia — have also found their services called upon by non-Jewish families. While it’s not clear exactly how many mohels offer nonritual circumcisions, the practice is, according to Shoulson — an Orthodox-trained mohel who has circumcised Muslims, Buddhists, Taoists and Hindus during his 50-year career — very widespread.

“Almost everybody else does it,” he said.

According to Blake and Shoulson, non-Jews make up between 2% and 5% of their clientele. Some, like the DeCaros, are motivated initially by practical circumstances, but others seem drawn to the mohels for spiritual reasons, if not explicitly religious ones. Both Blake and Sherman have even been approached by “Torah-observant Christians” — those dedicated to observing Old Testament commandments — seeking to have their sons circumcised on the eighth day after the birth. In all cases, families say they are drawn to the intimacy and convenience of a nonritual circumcision performed at home.

Manhattan pediatrician Susan Levitsky makes a point of recommending non-Jewish patients to mohels. Levitsky said she’s been passing out Sherman’s number more often these days, because concerns over hospital-bred infections are rising. “Why would you want to be around an environment with germs?” she asked. [Like the hasidim of New York are noted for their aseptic conditions?]

That’s precisely the question posed at www.holisticcircumcision.com, a site that Sherman set up for non-Jewish parents. On it, he describes a “quicker, gentler, and more humane” circumcision carried out without the use of “drugs, injections or creams” (he suggests sugar water or wine) in an environment that’s “spiritual and meaningful” instead of “clinical and cold.” ["Clinical and cold" are concerns of the parents, not the baby. Circumcision will be "gentle and humane" when it's without the use of surgery.]

...

Two months ago, Nate Sadeghi-Nejad and his wife, Janine Foeller, were denied a circumcision at New York-Presbyterian/Weill Cornell hospital because of a staph outbreak. After the first mohel the couple contacted refused to operate because they weren’t Jewish, Foeller’s postpartum doula gave them Sherman’s number.

Their son’s circumcision was a success. [If it hadn't been, would Sherman have been guilty of practising medicine without a licence, or what?] Foeller was comforted that Sherman used sugar water as a mild anesthesia [Would she have been "comforted" to have been given sugar water at his delivery?] instead of a topical pain reliever, while her husband — who worried about the “see one, do one, teach one” circumcision practices at hospitals — was impressed by Sherman’s know-how. “I’m a firm believer that any procedure, minor or major, should be done by the person who does it the most,” he said.

Mohels aren’t always second choices. Nearly two years ago, Jeannie Noth Gaffigan and Jim Gaffigan gave birth to their first son at home through the assistance of a nurse-midwife. Though the decision to circumcise wasn’t a religious one, as Catholics the Gaffigans wanted more than a simple medical procedure. ...

As a former obstetrician/gynecologist, Blake said she saw her work as a commitment to her patients [A healthy baby is not a patient.] ...

But Intactivists are "alarmist fanatics" for linking it to circumcision ...

Texas Football Succumbs to Virulent Staph Infection From Turf

Dec. 21 (Bloomberg) -- Missy Baker recalls the moment when she realized that her football-playing
son, Boone, didn't just have the flu.

``He told me he was paralyzed,'' Baker said. ``I said, `What do you mean? I just saw you walk to the
bathroom two hours ago.' And he said, `Mom, I can't move my arms or legs.'''

Sixteen-year-old Boone, a wide receiver for Texas's Austin High School, was suffering from a
recurrence of methicillin- resistant staphylococcus aureus, or MRSA, which his doctor said he got
through an abrasion from playing on artificial turf, Baker said.

Texas has artificial turf at 18 percent of its high school football stadiums, according to Web site
Texasbob.com. It also has an MRSA infection rate among players that is 16 times higher than the
estimated national average, according to three studies by the Texas Department of State Health
Services.

``This is a disease that can kill you,'' said Carolina Espinoza, a graduate epidemiology student at
the University of Texas in Houston, who helped conduct one of the studies. ``If I were a football
player, I would be alarmed.''

MRSA is a virulent strain of drug-resistant staph bacteria that plagued hospitals for decades and
migrated into the general population in recent years, said Edward Septimus, an infectious disease
specialist at Methodist Hospital System in Houston. Without proper treatment, it can spread to
internal organs and bones after reaching the bloodstream, causing organ failure, he said.

...

``The turf burns themselves are just the kind of minor skin injury that MRSA can exploit,'' said
Elliot Pellman, medical liaison for the National Football League, which also has had infections
among its players.

...

MRSA causes more deaths than any of the 51 infectious diseases tracked by the CDC, including AIDS,
according to CDC data. The agency doesn't require medical professionals to report MRSA cases.

... Researchers including Septimus blame MRSA's spread on overuse of antibiotics. A CDC report in the
Journal of the American Medical Association showed that MRSA caused three times more infections than
previously thought.

... Baker said she was shocked to learn how pervasive MRSA is. It's also persistent: Boone was
originally diagnosed in October 2006, and the infection returned last January. He had three
surgeries to remove infected tissue and spent three weeks in the hospital.

Uganda: Kasese, Bundibugyo Asked to Suspend Circumcision

Anne Mugisa
Kampala

THE Ministry of Health has asked the people of Bundibugyo and Kasese to suspend their circumcision ceremonies due this festive season until the Ebola epidemic is contained.

The commissioner for health services, Dr. Sam Okware, told journalists yesterday that the ministry is holding discussions with the communities to suspend the practice, adding that the district authorities should make by-laws to suspend circumcision.

Circumcision among the Bamba and Bakonjo was in the past conducted every five years but recently, the practice has been taking place between the end and the beginning of the year.

The health state minister, Dr. Emmanuel Otaala, said another suspected case of Ebola had been reported in Congo on the Bundibugyo border.

... He added that 39 patients, including six health workers, had recovered and were discharged.P> ... The remaining patients, he said, are expected to be discharged in a few weeks.
<

MASERU, LESOTHO -- A neighbor shaved Matsepang Nyoba's head with an antiquated razor. Blood beaded on her scalp. Tears trickled down her cheeks, but not because of the pain. She was in mourning, and this was a ritual.

Two days earlier, her newborn baby girl had died in the roach-infested maternity ward of Queen Elizabeth II, a crumbling sprawl that is the largest hospital in Lesotho, a mountainous nation of 2.1 million people surrounded by South Africa.

Nyoba, 30, whose given name means "mother, have hope," has AIDS. But that is not what killed her baby daughter, Mankuebe.

Nyoba owes her own life to the Bill & Melinda Gates Foundation, which has given $8.5 billion to global health causes. Through its grantees, including the Global Fund to Fight AIDS, Tuberculosis and Malaria, the foundation underwrites, inspires or directs major efforts to prevent, cure or treat those diseases. The fund pays for Nyoba's costly AIDS medicine.

But when she gave birth on a recent Sunday morning, her baby was suffering from a different kind of distress. The infant was limp and barely breathing. A nurse rushed her to the nursery, packed with sick babies, some two to a crib. Jury-rigged stethoscope tubes let six of the babies share lifesaving oxygen from a single valve.

There was no oxygen tube for Mankuebe. She asphyxiated for lack of a second valve. It would have cost $35.

The hospital, with no staff to move Mankuebe's remains to the morgue, placed her body on a shelf near the delivery room while her father arranged for burial. The tiny corpse was swaddled in a baby blanket. A handwritten death notice was stuck to the blanket with a used hypodermic needle.

The Gates Foundation, endowed by the personal fortunes of the Microsoft Corp. chairman, his wife and Berkshire Hathaway Inc. Chairman Warren E. Buffett, has given $650 million to the Global Fund. But the oxygen valve fell outside the priorities of the fund's grants to Lesotho.

Every day, nurses say, one or two babies at the hospital die as Mankuebe did -- bypassed in a place where AIDS overshadows other concerns.

Mixed effects

The Gates Foundation has targeted AIDS, TB and malaria because of their devastating health and economic effects in sub-Saharan Africa. But a Times investigation has found that programs the foundation has funded, including those of the Global Fund and the GAVI Alliance, which finances vaccines, have had mixed influences on key measures of societal health:

By pouring most contributions into the fight against such high-profile killers as AIDS, Gates grantees have increased the demand for specially trained, higher-paid clinicians, diverting staff from basic care. The resulting staff shortages have abandoned many children of AIDS survivors to more common killers: birth sepsis, diarrhea and asphyxia.

The focus on a few diseases has shortchanged basic needs such as nutrition and transportation, undermining the effectiveness of the foundation's grants. Many AIDS patients have so little food that they vomit their free AIDS pills. For lack of bus fare, others cannot get to clinics that offer lifesaving treatment.

Gates-funded vaccination programs have instructed caregivers to ignore -- even discourage patients from discussing -- ailments that the vaccinations cannot prevent. This is especially harmful in outposts where a visit to a clinic for a shot is the only contact some villagers have with healthcare providers for years.

The Gates Foundation's largest grants for healthcare in Africa go to two organizations: the Global Fund and Geneva-based GAVI. The foundation formed GAVI and has given it $1.5 billion of more than $1.8 billion it has donated for vaccination programs. The Gates Foundation holds a seat on each group's board of directors and helps determine their policies and priorities.

Because of the generosity of the foundation and other donors, millions of children have been protected against scourges such as malaria and measles -- and AIDS deaths in much of Africa are finally leveling off. Dr. Mphu K. Ramatlapeng, Lesotho's health minister, echoed health authorities worldwide when she said this would have been impossible "if it were not for the money from Bill Gates."

But because of the overwhelming nature of AIDS, wartime disruptions and poor governance in some nations -- and because of the priorities of global health groups, including GAVI and the Global Fund -- key measures of societal health have stalled at appalling levels or worsened.

...
By 2005, health expenditures per capita in Botswana, boosted by the Gates donations, were six times the average for Africa and 21 times the amount spent in Rwanda.

Deaths from AIDS fell sharply.

But AIDS prevention largely failed. HIV continued to spread at an alarming pace. A quarter of all adults were infected in 2003, and the rate was still that high in 2005, according to the U.N. Program on HIV/AIDS. In a 2005 survey, just one in 10 adults could say how to prevent sexual transmission of HIV, despite education programs.

...

Yamada, the Gates Foundation official, said research was needed to determine whether "vertical" aid, such as the foundation's Botswana program, had contributed to brain drain and higher mortality.

To bolster basic healthcare in Africa, he proposed that universities in rich nations help found medical schools on the continent. And he challenged African nations to spend at least 15% of gross domestic product on health.

As of 2004, only 13 countries worldwide spent as much as 10%, and only one African country, Malawi, is among them.

Yamada said the foundation had asked Botswana to focus more on AIDS prevention -- including circumcision, which can reduce susceptibility to HIV.

"I don't know what to do there, frankly," to reduce unsafe sex, short of "changing the hearts and minds of the people," he said.

Islamic scholar opposes ban on female circumcision

Marwa Al-A'Sar | Cairo, Egypt

In an act that has sparked outrage among Egyptian women's rights activists, a controversial Islamic scholar filed a lawsuit against the minister of health protesting against a recent ban on female circumcision, a practice referred to by rights groups as female genital mutilation (FGM).

Conservative Muslim and Christian Egyptian families have their daughters circumcised as a means to preserve their chastity. Recent studies revealed that about 90% of Egyptian women have been subjected to the practice.

In June, the Health Ministry banned doctors and nurses from carrying out the procedure. The announcement followed the death of an 11-year-old girl in Upper Egypt as a result of the procedure. Medics who carry out circumcisions may face imprisonment and being stripped of their medical licences.

While al-Badri argues that the practice is necessary in curbing women's sexual inclinations, women's rights activists and physicians disapprove of his view.

"Many of the circumcised women who seek our help were traumatised, having no ability to lead a normal sex life, which affects their relationships with their husbands," said Nihad Abul-Qomsan, head of the Egyptian Centre for Women's Rights.

She accused Muslim sheikhs in the Arab world of being distracted from the vital issues. "No one of the sheikhs coming up with such arguments has ever considered in his agenda the deteriorating socio-economic conditions we are undergoing," she noted. "Instead they try to play the role of the Islam advocates."

Egypt's top Islamic and Christian authorities were quick to voice support for the ban, saying the practice had no basis either in the Qur'an or in the Bible.

"The Constitution is based on the Islamic sharia law, which does not stipulate FGM, giving a wife the right to enjoy sex with her husband," Khalil Mustafa Khalil, who holds a master's degree in FGM legislation, told the independent al-Badeel newspaper.

Forcible circumcision heads for court

A civil society organisation says it is to launch Equality Court proceedings on behalf of an Eastern Cape youth said to have been forcibly circumcised.

The Justice Alliance of SA (Jasa) said on Tuesday it had agreed to act free of charge for 19-year-old Bonani Yamani.

It claimed he was subjected to traditional circumcision in March 2007 after having himself circumcised at East London's Frere Hospital three months earlier.

"Bonani had made it clear that his conscience and religious beliefs did not allow him to undergo the traditional Xhosa rite," Jasa said in a statement.

Yamani is reportedly a devout Christian.

Jasa said it had written in October 2007 to Ngangomhlaba Matanzima, head of the Eastern Cape House of Traditional Leaders, and provincial leader of the Congress of SA Traditional Leaders Mwelo Nkonyana, asking for an apology to Yamani and an assurance that no one else would be subjected to circumcision against his will.

There had been no response.

"We have accordingly written again to both chiefs saying that we have no choice but to commence proceedings in the Equality Court ... on behalf of Bonani," Jasa said.

The Cape Town-based Jasa, which describes itself as "a coalition committed to the highest moral values in South African society", has previously been involved in anti-abortion lobbying. - Sapa

So now it's all about race...?

December 4, 2007

Circumcision does not affect HIV in U.S. men

Removing foreskin no protection for American men of color, study finds

WASHINGTON - Circumcision may reduce a man's risk of infection with the AIDS
virus by up to 60 percent if he is an African, but it does not appear to help
American men of color, U.S. researchers reported on Monday.

Black and Latino men were just as likely to become infected with the AIDS
virus whether they were circumcised or not, Greg Millett of the U.S. Centers
for Disease Control and Prevention found.

"We also found no protective benefit for a subset of black MSM (men who have
sex with men) who also had recent sex with female partners," Millett told
reporters in a telephone briefing.

[Some] Doctors believe circumcision protects men because of specialized cells in the
foreskin of the penis, which is removed in the procedure. The foreskin is
filled with immune cells called Langerhans cells, which are the immune
system's sentinels and attach easily to viruses - including HIV.

In addition, sexual intercourse may cause tiny tears in the foreskin [or the remainder of the penis],
allowing the virus into the bloodstream.

The data has been so clear that the World Health Organization now recommends
circumcision as one of the ways to prevent HIV infection. But circumcision
does not protect men 100 percent - the studies in Africa have suggested it is
50 to 60 percent protective.

Millett's team studied 1,079 black and 957 Latino bisexual and homosexual men
from New York City, Los Angeles, and Philadelphia. They filled out a computer
survey and were tested for the AIDS virus.

"Overall, we found no association between circumcision status and HIV
infection status among black or Latino (men who have sex with men)," said
Millett, who presented his findings to the CDC's National HIV Prevention
Conference in Atlanta.

But Millett's study found no benefit of circumcision to any of the men. "We
also found no protective benefit of circumcision among those men reporting
recent unprotected sex with a male partner in which they were exclusively the
insertive male partner," he said.

HIV is much more common among black and Latino men than whites and this may
offset any protection offered by circumcision, Millett said. [What does this mean? Circumcision is most protective where there is no risk of HIV?] Black and Latino
men are more likely to have sex with other black and Latino men, and thus may
be exposed to HIV more often than white men. [Or perhaps race has nothing to do with it, and the studies claiming a circumcision connnection are wrong.]

The CDC is about to release new estimates of how many people become infected
with the fatal and incurable human immunodeficiency virus each year in the
United States.

The CDC estimates that more than 1 million Americans are infected, of the 33
million infected people globally.

Circumcision 'Aids prevention'

Lusaka - A southern African radio correspondent has been receiving a flood of text messages and cellphone calls - some from offended listeners and readers.

The response isn't to a story on politics, corruption or soccer - all topics likely to elicit passionate responses.

Rather, Zambia-based Kennedy Gondwe said in an interview on Friday, he was attracting attention because he chose to get circumcised as a way of protecting himself from Aids, and took the British Broadcasting Corp's radio and web audience through the procedure with him.

... Gondwe, a 27-year-old who said he undergoes an Aids test several times a year, said he found it "sad" that more people didn't talk about circumcision as a prevention method. [Without knowing how many women he has sex with and whether he uses condoms, it's still unknown how much risk he is at.]

He said: "We as journalists also have a role to play in the fight against the disease." Gondwe, on the radio piece and in an online diary on Friday, recounted going [for] the procedure on November 22.

SA 'hardest hit by Aids'

Listeners could hear him gasp as a doctor injected him with a local anesthetic, but he assured them that the procedure was otherwise painless. He was up, walking to his car and driving himself home soon afterward. [Which gives the lie to the claim that the procedure is more serious than in a baby.]

...
While one admiring web reader from Zambia told Gondwe he would soon follow his example, the reporter said others were offended in a region, where in some communities, tradition frowned upon circumcision. Gondwe's Tumbuka people of Zambia's Northern Province did not embrace circumcision, he said.

[The BBC version of this story printed only pro-circumcision responses.]

Half of U.S. doctors mum about incompetence: survey

WASHINGTON (Reuters) - Nearly half of all U.S. doctors fail to report
incompetent or unethical colleagues, even though they agree that such
mistakes should be reported, researchers said on Monday.

They found that 46 percent of physicians surveyed admitted they knew of a
serious medical error that had been made but did not tell authorities about
it.

... In 2000, the U.S. Institute of Medicine reported that up to 98,000 people die
every year because of medical errors in hospitals alone.

Campbell and colleagues surveyed more than 1,600 physicians in 2003 and 2004
for their report, published in the Annals of Internal Medicine.

...
Forty percent of the doctors said they knew of a serious medical error in
their hospital group or practice but 31 percent admitted they had done
nothing about it at least once.

... And medical boards may not have the resources to punish errant doctors.
"There are restrictions on state medical boards that inhibit their ability to
go after physicians aggressively," [Dr. James] Thompson[, chief executive officer of the Federation of State
Medical Boards,] said.
"There are state medical boards that don't even have their own teams of
investigators," he added. "There are state medical boards that are, quite
frankly, underfunded and understaffed."

China AIDS rate slows, main transmission now sex

By Ben Blanchard
Reuters

BEIJING (Reuters) - The rate of new HIV/AIDS infections in China is slowing and is now mainly being transmitted through sex, which the government could tackle with a circumcision campaign, the health minister said on Thursday.

The country will have an estimated 50,000 new infections in 2007, compared with 70,000 in 2005, though groups like men who have sex with men are increasingly at risk, according to a report by the State Council, or Cabinet, and the United Nations.

COMMENTNo comments have been posted about this item.
Comments are closed for this article.

That will mean there will be about 700,000 people living with HIV/AIDS this year in China, up from an earlier estimate of 650,000.

Of the new infections, 44.7 percent will come from heterosexual transmission, 12.2 percent from men having sex with men, and 42 percent from intravenous drug use, the report said.

In the past, most infections were caused by intravenous drug use.

"At present, the AIDS epidemic in China continues to spread, but at a slower rate," Health Minister Chen Zhu told a news conference. "Sexual transmission is now the main route for the spread of AIDS."

Chen said more focus needed to be put on traditionally marginalized groups, like the gay community and drug users, though he added condom use by sex workers had risen from 14.7 percent in 2001 to 41.4 percent last year.

Yet the report found risky behavior by men who have sex with men remained widespread, with just a third using condoms for anal sex.

Chen said that with infections now primarily coming via sexual transmission, a male circumcision campaign could not be ruled out in China.

Studies have shown that circumcision could reduce the risk of HIV infection by up to 60 percent, though it does not offer total protection from the virus.

The World Health Organisation has already recommended it as one of the ways developing countries, especially in Africa, could use to fight the spread of AIDS.

"This is a technical question. I think our experts will evaluate it," Chen later told Reuters. "Even before the AIDS era some children in China were already being circumcised."

Circumcision rates are low in China compared to Asian countries like South Korea or Japan [not so], where the foreskin is often removed at birth for hygiene reasons, or Muslim countries like Indonesia which practice it for religious reasons.

China's Muslim minority, concentrated in the far western region of Xinjiang, likewise circumcise their male children, normally as they reach puberty.

Chen said that were the government to decide to promote circumcision among the wider population, he did not think it would run into much opposition or cultural problems.

"As long as there is evidence it is effective, I don't think it would be an issue," he said.

(Editing by Jeremy Laurence [One wonders whether Minister Chen proffered his comments or was asked some leading questions to elict his cautious replies.])

Nigerian baby bled to death after botched circumcision

The results of an autopsy performed on an 18 day old baby boy who died in suspicious circumstances in Tarragona last weekend, reveal that the baby died of massive blood loss following a botched circumcision thought to have been performed by the baby's mother, who has been questioned, but not arrested.

The incident occurred at around 9.30pm last Sunday evening at the home of the boy's parents, a Nigerian couple, who live in Tarragona's Pilar district.

Unjha doctors strike work

Ahmedabad, November 19 Doctors in the north Gujarat town of Unjha stayed off
their clinics and hospitals on Monday, refusing to take up even emergency
cases, which they diverted to the Government hospital. The strike was in
protest against the attack on a hospital by relatives of a patient on
Sunday. The hospital was vandalised, vehicles gutted and two doctors were
manhandled on Sunday.

According to Dr Anil Patel, vice-president of Unjha Medical Association,
trouble started after Kuldeep Kumar Vishnubhai Patel (10), who had undergone
a minor surgery for circumcision at Anand Hospital on Sunday morning, died
about two hours later. Dr Patel, who is an anaesthetist, was present during
the operation which was performed by Dr P K Patel. "The surgery was
successful but due to the carelessness shown by the relatives, the boy died
in a couple of hours. The death enraged them and they attacked the hospital.
We could save our lives only by bolting the doors from inside until police
came. They had to control the situation by bursting teargas shells," said Dr
P K Patel. He said that the boy was brought from nearby Unava town for
circumcision on medical grounds.

Cross complaints were lodged and police had provided protection to the
doctors following threat to their lives. "We have already got the
post-mortem examination done to ascertain the reason of death and are
awaiting the report," he further said.

Till reports last came in, a meeting of local NGOs and prominent people was
to be held on Monday evening to express support for the doctors. All the 33
doctors in Unjha and another 30 in surrounding areas remained on strike.
Asked if people would suffer because of denial of emergency treatment, Dr
Anil Patel said there were not many patients because of the festive season.

Dr Bipin Patel, honorary general secretary of state branch of Indian Medical
Association said that the Government should take strict action against those
responsible for the attack on doctors. According to Unjha police, they have
registered cross complaints in this case and inspector C R Parmar is
investigating the case.

`Revolutionary' Method Gives Skin Cells Power of Embryo Cells

By Rob Waters and John Lauerman

Nov. 20 (Bloomberg) -- Ordinary skin cells from the face of a 36-year-old woman and the foreskin of a newborn infant were turned into stem cells with the apparent power to become any cell in the body by two research teams working independently.

The two groups, one in Japan and the other in the U.S. [It would be much harder to find a detached foreskin in Japan], each inserted four genes into the skin cells that switched on a process converting them into a form equivalent to embryonic stem cells. Those cells were then changed into heart, brain, muscle, fat and cartilage cells by one of the teams using a proven method for growing tissue from embryonic cells.

The technique could shift the ethics debate by ending use of human embryos [no mention of the ethics of using pillaged foreskins] and leapfrog ongoing studies by hundreds of small companies, including Geron Corp. and Advanced Cell Technology Inc. in the U.S. It could allow organs and tissues to be more easily created with one's own cells [in the US, one's own foreskin may not be available] and, more immediately, give drugmakers a new way to test how new compounds interact with diseased cells, scientists said.

``It will revolutionize the way in which we study and treat human disease,'' said Ian Wilmut, the Scottish cell biologist who shocked the world when he cloned a sheep named Dolly more than 10 years ago, ushering in a new era of scientific exploration and ethical conflict. He predicted Yamanaka's work would earn him a Nobel Prize.

The new method was first perfected in mice by Shinya Yamanaka of Kyoto University last year. It may eliminate the push for so-called therapeutic cloning of human embryos as a way to create stem cells that genetically match a person, Wilmut said in a telephone interview yesterday.

Pursuit EndsAs a result, he said he'd no longer pursue that strategy in his work at the Scottish Center for Regenerative Medicine at the University of Edinburgh.

``We decided some weeks ago that we were not going to pursue'' human cloning, Wilmut said. ``It seems more likely that you'd get an effective or reliable source of stem cells from the Yamanaka procedure.''

The two breakthroughs were simultaneously released today in the journals Science and Cell. The research teams were led by Yamanaka and James Thomson, the University of Wisconsin biologist credited as the first to isolate stem cells from human embryos and keep them alive.

Last week, an announcement by Oregon researchers that they had cloned a monkey embryo and extracted stem cells from it had drawn fresh excitement within the scientific community. Now that accomplishment has been overtaken, scientists said.

The transformed skin cells, or ``induced pluripotent cells,'' as Yamaka calls them, showed they could turn into cardiac, brain, muscle, fat and cartilage cells, among other cell types, Yamanaka said. To get them to morph into cardiac cells, they followed a recently-published paper that described how to make them from embryonic stem cells.

`Beating Cardiac Cells'``We just applied the same protocol to human pluripotent cells and it works,'' Yamanaka said. ``It's amazing. Those cells were skin cells only two to three weeks ago and now they are beating cardiac cells in a dish.'' One of the properties of cardiac cells is that they rhythmically, and visibly, contract.

Because his procedure is relatively simple to perform -- far easier than cloning -- it can be followed and replicated in thousands of labs around the world, Yamanaka said in a Nov. 16 telephone interview.

``You don't need any special equipment and we don't need any special techniques,'' he said. ``All we need is equipment for cell culture and for gene transfer. There may be 10,000 or more labs in the world that could make'' these cells.

While Thomson and Yamanaka each used four genes to reprogram the cells, only two were the same.

To contact the reporter on this story: Rob Waters in San Francisco at rwaters5@bloomberg.net .
Last Updated: November 20, 2007 09:10 EST

[The fact that facial skin cells work in the procedure means there is no need to harvest foreskins for this purpose.]

U.N. to Cut Estimate Of AIDS EpidemicPopulation With Virus Overstated by Millions

By Craig Timberg
Washington Post Foreign Service

JOHANNESBURG, Nov. 19 -- The United Nations' top AIDS scientists plan to acknowledge this week that they
have long overestimated both the size and the course of the epidemic,
which they now believe has been slowing for nearly a decade, according
to U.N. documents prepared for the announcement.

AIDS remains a devastating public health crisis in the most heavily
affected areas of sub-Saharan Africa. But the far-reaching revisions amount to at least a
partial acknowledgment of criticisms long leveled by outside researchers
who disputed the U.N. portrayal of an ever-expanding global epidemic.

The latest estimates, due to be released publicly Tuesday, put the number of annual new HIV infections at 2.5 million, a cut of more than 40 percent from last year's estimate, documents show. The worldwide total of people infected with HIV -- estimated a year ago at nearly 40 million and rising -- now will be reported as 33 million.

Having millions fewer people with a lethal contagious disease is good news. Some researchers, however, contend that persistent overestimates in the widely quoted U.N. reports have long skewed funding decisions and obscured potential lessons about how to slow the spread of HIV. Critics have also said that U.N. officials overstated the extent of the epidemic to help gather political and financial support for combating AIDS.

"There was a tendency toward alarmism, and that fit perhaps a certain fundraising agenda," said Helen Epstein, author of "The Invisible Cure: Africa, the West, and the Fight Against AIDS." "I hope these new numbers will help refocus the response in a more pragmatic way."

Annemarie Hou, spokeswoman for the U.N. AIDS agency, speaking from Geneva, declined to comment on the grounds that the report had not been released publicly. In documents obtained by The Washington Post, U.N. officials say the revisions stemmed mainly from better measurements rather than fundamental shifts in the epidemic. They also say they are continually seeking to improve their tracking of AIDS with the latest available tools.

Among the reasons for the overestimate is methodology; U.N. officials traditionally based their national HIV estimates on infection rates among pregnant women receiving prenatal care. As a group, such women were younger, more urban, wealthier and likely to be more sexually active than populations as a whole, according to recent studies.

The United Nations' AIDS agency, known as UNAIDS and led by Belgian scientist Peter Piot since its founding in 1995, has been a major advocate for increasing spending to combat the epidemic. Over the past decade, global spending on AIDS has grown by a factor of 30, reaching as much as $10 billion a year.

But in its role in tracking the spread of the epidemic and recommending strategies to combat it, UNAIDS has drawn criticism in recent years from Epstein and others who have accused it of being politicized and not scientifically rigorous.

For years, UNAIDS reports have portrayed an epidemic that threatened to burst beyond its epicenter in southern Africa to generate widespread illness and death in other countries. In China alone, one report warned, there would be 10 million infections -- up from 1 million in 2002 -- by the end of the decade.

Piot often wrote personal prefaces to those reports warning of the dangers of inaction, saying in 2006 that "the pandemic and its toll are outstripping the worst predictions."

But by then, several years' worth of newer, more accurate studies already offered substantial evidence that the agency's tools for measuring and predicting the course of the epidemic were flawed.

The downward revisions also affect estimated numbers of orphans, AIDS deaths and patients in need of costly antiretroviral drugs -- all major factors in setting funding levels for the world's response to the epidemic.

James Chin, a former World Health Organization AIDS expert who has long been critical of UNAIDS, said that even these revisions may not go far enough. He estimated the number of cases worldwide at 25 million.

"If they're coming out with 33 million, they're getting closer. It's a little high, but it's not outrageous anymore," Chin, author of "The AIDS Pandemic: The Collision of Epidemiology With Political Correctness," said from Berkeley, Calif.

The picture of the AIDS epidemic portrayed by the newer studies, and set to be endorsed by U.N. scientists, shows a massive concentration of infections in the southern third of Africa, with nations such as Swaziland and Botswana reporting as many as one in four adults infected with HIV.

Rates are lower in East Africa and much lower in West Africa. Researchers say that the prevalence of circumcision, which slows the spread of HIV, and regional variations in sexual behavior are the biggest factors determining the severity of the AIDS epidemic in different countries and even within countries. [Then how come HIV is more prevelent in several countries with high circumcision rates than other countries with low rates?]

Beyond Africa, AIDS is more likely to be concentrated among high-risk groups, such as users of injectable drugs, sex workers and gay men. More precise measurements of infection rates should allow for better targeting of prevention measures, researchers say.

[If HIV is less prevalent than was thought, then circumcision is less efficacious than they calculated - the number of circumcisions needed to prevent each transmission, and hence the cost per transmission prevented, is higher.]

URGENT APPEAL: Please Help Protect Ayaan Hirsi Ali

Ayaan Hirsi Ali is the most prominent advocate of free speech and women's rights in the Muslim world, and for this she must live under perpetual armed guard, even in the West. Unfortunately, on October 1st of this year, the Dutch government officially rescinded its promise to protect her. Now, Ayaan Hirsi Ali's friends, colleagues and admirers must come to her aid [if she may ever safely leave Holland].

I have created a page on my website that links directly to the Ayaan Hirsi Ali Security Trust. The money raised by this trust will pay Ayaan Hirsi Ali's security expenses. In the event that money remains after these costs have been met, it will be used to encourage and protect other dissidents in the Muslim world.

The ongoing protection of Ayaan Hirsi Ali is a moral obligation. It is also a strategic one: for here is a woman doing work that most of us cannot do--indeed, would be terrified to do if given the chance--and yet this work is essential for preserving the freedoms we take for granted in the West.

If every reader of this email simply pledged ten dollars a month to protect Ayaan Hirsi Ali, the costs of her security would be covered for as long as the threat to her life remains.

Thanks in advance for your support.

Sincerely,
Sam Harris

Ayaan Hirsi Ali
In 2005, TIME included Ayaan Hirsi Ali in its list of the World's 100 Most Influential People. If you would like to know more about her, please read Christopher Caldwell's fine profile in the New York Times Magazine. You can also read the essay that Salman Rushdie and I recently published in the Los Angeles Times, or the one that Christopher Hitchens wrote for Slate.

Cosmetic circumcision banned

CIRCUMCISION will be banned in the state's public hospitals unless it is
for medical reasons.

Health Minister John Hill today will announce an immediate ban on
"cosmetic" circumcision.

"The Health Department has a responsibility to ensure access to elective
surgery is based on sound medical reasons," he said yesterday. "Cosmetic
procedures such as liposuction, facelifts and male circumcision will only
be provided if assessed and justified on true clinical grounds.

"This will improve the demand on beds, clinical resources and theatre time."

In the past financial year, 274 circumcisions were p! erformed on children
in the state's public hospitals. SA is the last state to take a stand
against circumcision. "Both nationally and overseas, doctors agree there
is no medical benefit to routine circumcision with the procedure as low as
2 per cent in the UK," Mr Hill said.

"Parents who wish to have their son circumcised can still have the
procedure done in private hospitals or private day centres."

Australian Medical Association state president Peter Ford said
circumcision was controversial and it was "not unreasonable" that other
procedures take priority in a system under pressure.

Patients already on the waiting list will still be able to have the
surgery in the public system but anyone not allocated an appointment will
not be eligible.

Male circumcision is a promising addition to Uganda’s HIV preventive strategies and once implemented it has potential to reduce HIV infection among circumcised males. Uganda and the rest of the world are fortunate to have an additional intervention that will support the fight against the epidemic. However wide-scale implementation is premature in Uganda.

First, although several research studies that compared circumcised and uncircumcised males in several African countries including one from Rakai district in Uganda showed that circumcised males were less likely to acquire HIV than their uncircumcised counterparts, there is a big difference between what can be achieved in a study setting and the results of a public health intervention. Conditions in a clinical trial are carefully controlled and results may not really be as glowing as those from a study situation where both the study staff and participants are well motivated.

For example while side effects from surgery were minor under study conditions, they may be enormous under field conditions given the current challenges faced by Uganda’s hospital surgery departments such as few and less motivated personnel, lack of proper equipment, shortage and frequent stock out of drugs and consumables.

Secondly, there may be behaviour disinhibition where people who are circumcised may incorrectly assume they are not at risk of HIV infection. Such an incorrect conclusion may lead individuals who are HIV-negative at the time of circumcision to maintain or increase their current level of HIV-risk behaviour putting themselves and their sexual partners at risk.

Similarly, HIV positive individuals may seek surgery and incorrectly think they will not transmit HIV. Hospitals implementing circumcision may not have the capacity to screen all their clients for HIV before offering circumcision, thus circumcised males may create another risk category in HIV prevention.

Male circumcision may also take away resources and attention from other prevention methods that have effectively reduced the HIV prevalence in Uganda, namely abstinence, faithfulness and condom use. In fact, those prevention efforts have already earned Uganda the coveted position as an international success story in reducing the number of people being infected with HIV (though this assertion is still being questioned and is an open debate; what worked in Uganda?).

The cost for each circumcision in the Rakai study was over $60. This is a cost ten or more times the annual budget for health for an individual. Is it worth diverting the prevention budget away from methods that seem to work for a fraction of the cost to try something that has only been tested in a study setting? I don’t think so.

Museveni Cautions Youth On Circumcision

By Fortunate Ahimbisibwe

Kampala
PRESIDENT Yoweri Museveni has said circumcision should not be promoted in the
fight against HIV/AIDS, as it will encourage recklessness among the youth.

Addressing over 500 youth delegates who attended the Youth Activist Forum on
Tuesday at Hotel Africana in Kampala, Museveni said he would continue advocating
for the ABC strategy (Abstinence, Faithfulness and Condoms.)

"Some NGO's have been saying rubbish about circumcision but I will continue
encouraging the youth to abstain, and use condoms only if they must. How many
Bagisu have died of AIDS and yet all of them are circumcised?" he asked.

"You would rather use a condom as a fall-back position but not rely on
circumcision."

Museveni warned the youth against contracting HIV/AIDS and encouraged them to
get married immediately after school.

"By the time you get your first degree when you are 24, you should find a
responsible partner and enjoy the rest of your lives together. Getting a partner
should be a process but not meeting in the bus park and getting married."

...

The forum, a precursor to the Commonwealth Youth Forum to take place in Kampala
later this month, was organised by the Global Forum for International
Cooperation.

Ore. Court Mulls Circumcision Case

SALEM, Ore. — Six justices of the Oregon Supreme Court are wrestling with the question of what to do when divorced parents disagree about whether a child should be circumcised.

For an hour yesterday, the judges heard arguments in a child custody dispute between James Boldt, who wants his son circumcised as part of the son's conversion to Judaism, and the child's mother, Lia Boldt, who went to court to block the procedure. The child, who was 9 at the time the issue arose in 2004, is now 12.

A county judge dismissed Mrs. Boldt's challenge, but blocked the circumcision from taking place until all appeals were exhausted. The mother's attorney, Clayton Patrick, told the court that the circumcision posed "an unreasonable and unnecessarily high risk to the child." Mr. Patrick was quickly challenged by Judge W. Michael Gillette, who asked whether courts should step in when a divorced couple disagrees about whether a child should play football. [Maybe if football inevitably modified a child's body for life...?]

"More people get hurt playing football than from having a circumcision and a lot more seriously," Judge Gillette said. [Death is the most serious outcome in both cases.] He said family court disputes over going out for football were a "necessary consequence" of the mother's position. "That's preposterous. I hope you recognize that cannot work," the judge said.

Mr. Patrick said that, even though the father had full custody of the child, the mother was entitled to a court hearing because, based on her review of information about circumcision, the practice amounts to "sex abuse or physical abuse."

"If the custodial parent wanted to amputate some other body part, I think the court would step in and say you can't do that," the attorney said. Mr. Boldt, other family members and the doctor who would perform the circumcision said the boy wanted it. However, Mrs. Boldt said her son told her that he did not want to be circumcised and was afraid to contradict his father. Some of the justices asked whether the courts should take the child's views into account, either when he was 9 or at age 12.

"The child's wishes, while of course they should be considered, are not legally decisive or, legally speaking, relevant," Mr. Boldt, who is a lawyer and has represented himself in the legal proceedings, said. Judges speculated about whether custodial parents had the right to impose genital mutilation or a nose job "on children whose faces are just fine." "Are there no limits?" one judge asked.

When Mr. Boldt said he thought a custodial parent could do anything that wasn't illegal to a child, Judge Rives Kistler replied, "That seems a real broad claim. What if they wanted to have tattoos put on the child's face?"

Mr. Boldt said some actions might be so outrageous that they called into question a person's fitness as a parent. A tattoo on a child's shoulder that says "Mom" would be a different matter than "a swastika on the forehead," he said. [How different?]

Mr. Boldt insisted that the court should not single out circumcision for greater scrutiny than other parenting choices. "There's no principled, intellectually defensible, legally supportable reason to extract that one category," he said. Much of the hearing discussed whether Mrs. Boldt was automatically entitled to a formal evidentiary hearing on her objection and, if not, what evidence she had to produce to get such a hearing.

The Oregon jurists appear to be the highest-ranking American court to hear a dispute involving circumcision, according to a New York University law professor who has written on the issue, Geoffrey Miller. "It will be a precedent that will be closely paid attention to by people who are interested in that debate," the professor said. "I would be quite shocked or at least surprised if the result in the Oregon Supreme Court undoes what the lower courts said."

A Portland rabbi who attended the argument, Daniel Isaak, said he was surprised that there was little discussion of the religious freedom aspect of the case. "Circumcision is a basic rite of conversion" for Jewish men and is also practiced by Muslims, the rabbi said.

The anti-circumcision brief notes that during a prior court proceeding unrelated to the circumcision issue, the Boldts agreed that they had a dominant-submissive relationship — in which Mr. Boldt was "god" or "sovereign" — and that sometimes involved Mr. Boldt administering beatings to his wife, who assumed the role of "slave girl." The Boldts' son "must not be abandoned by the courts, to become embroiled in his father's need for a replacement slave … if that is what happened," the anti-circumcision group argued.

Mr. Boldt declined to be interviewed as he left court yesterday. The groups defending circumcision stated in their brief that they were taking no position on "who is the more appropriate parent."

ABC, not circumcision, gives best defence against HIV

By David J. Llewellyn

DR. Myers Lugemwa is to be congratulated on his insightful article on
the attempt to circumcise Uganda by US doctors. It is so obvious that
Abstinence, Being Faithful and Condoms (ABC) are the only rational
defense against the HIV virus, that it is hard to believe that many
in the international health community have bought into the ridiculous
"circumcise to prevent HIV" theory.

The best way to prevent sexually-transmitted HIV and all other
venereal diseases is by ABC. It is that simple.

It appears that there may be more to the push for circumcision than
merely the improvement of public health. Some of those pushing this
strategy have their academic reputations and careers on the line.
Others have familial traditions that emphasise circumcision. For
example, Daniel Halperin, one of the foremost proponents of the
"circumcise to prevent HIV" movement, admitted in a newspaper article
years ago that his grandfather had been a part-time Jewish ritual
circumciser. He has also been quoted as saying that women like
circumcised men and that sex is better if you are circumcised - two
very subjective statements with which most uncircumcised men and
their wives would disagree. Others may feel the need to validate
their own circumcised status or academic theories by encouraging
others to be circumcised.

Two of the primary authors of the recent randomised controlled trials
recently have collaborated with long-time proponents of circumcision
on the formulation of a pamphlet encouraging women worldwide to push
their husbands to be circumcised and to circumcise their sons. One of
those proponents, a circumcised middle-aged Australian, the primary
author of the pamphlet, has written that circumcision is "an
imperative" for the 21st Century!

As the Trojans learned, one should always "beware of Greeks bearing
gifts," even if those "Greeks" are Americans. Ugandans should know
that one of the early proponents of medicalised circumcision in the
US, Peter Remondino, M.D., in the late 19th Century advocated
circumcising all black Americans to prevent what he called "the Negro
rape crisis."

Modern day Ugandans may wish to consider whether or not the US push
to circumcise them has any similar patronising, racist overtones or
overtones of colonialism.

We know that the foreskin is an integral part of the penis. A recent
study has shown that it is the most sensitive part of the penis.
Earlier unrefuted studies proved that it contains most of the fine
touch nerve receptors in the penis. It may well mediate the
ejaculatory reflex.

It makes intercourse easier and more enjoyable for both the man and
the woman. No rational man would give up his foreskin if he realised
the sexual consequences. It is immoral and unethical to remove
normal, sexually-valuable tissue from an infant or child, male or
female, without present medical necessity. Ugandans should think
twice about what they would be losing before agreeing to circumcision
for themselves or their sons.

That Americans may still circumcise the majority of their sons is not
an example to emulate.

As Dr. Lugemwa points out, circumcision began in the US in a vain
attempt to prevent masturbation. Of course, it did not work. But
Americans became invested with their circumcised penises and it has
proven challenging to change their minds. Nevertheless, Ugandans
should know that the rate of circumcision in the US has been dropping
slowly for the last 30 years as the public has learned of the value
of the foreskin. In California and some other western states, the
circumcision rate for newborn boys is below 35%.

Ugandans should also know that circumcision did not prevent HIV from
wrecking havoc in the US. The US has a much higher rate of HIV
infection and a much higher rate of circumcision than does Europe.
This puts the lie to the hypothesis that circumcision "prevents" HIV.
It is not a "vaccine," although its proponents would like Ugandans to
believe that it is. One might reasonably wonder what the real motive
is behind those who would try to sell a mutilating surgery to others
with such hyperbole.

Cutting comments: the foreskin debate

Some say it’s barbaric, others a matter of hygiene. But with babies dying from circumcision, should it continue? Our correspondent hears from the ‘intactivists’Simon Mills

The actor Alan Cumming gets quite a reaction when he drops his trousers. Especially in America. Why? His penis is uncircumcised. He is genitally intact, a cavalier rather than a roundhead. His johnson wears an opera cape, as they say in US gay circles. This gives him something akin to freak status in the hygiene-obsessed States, where 70% of the mature male population have been circumcised.

Cumming, an endearingly puckish type, is really rather proud of his foreskin. “During interviews in America, I have made a point of talking about it,” he says. “I think it’s insane that an entire nation is ignorant about a part of their body they have lost. When I take my pants off in America, people gasp, which is kind of nice, until I realise that they’re actually staring at my penis as if it’s some kind of National Geographic photo come to life. Nobody has a foreskin there. They’re, like, ‘Wow! What do you do with that? How does it work?’ ”

Why is it that so many American men are circumcised? Well, it seems the Brits are responsible. Queen Victoria, who, along with much of the British aristocracy, believed that the English descended from one of the Ten Lost Tribes of Israel, chose to have her sons circumcised. It became fashionable, and the procedure travelled to America. It was there that John Harvey Kellogg campaigned for circumcision as a cure for masturbation, which was, in his opinion, a cause of psychological problems. And ever since (in the 1950s, it is estimated, 90% of American boys were snipped), middle-class Americans have grown up believing that foreskins are filthy, wholly unnecessary fleshy adjuncts that harbour disease and make a sensitive teenage boy something of a fairground attraction in the communal-shower environment.

That’s why the uncut likes of Nick Nolte, Leonardo DiCaprio, Willem Dafoe, Emilio Estevez, Nicolas Cage and Keanu Reeves, all born during the barbaric period of the last millennium, are listed on pro-foreskin websites as if they were all some kind of heroic locker-room maverick.

Blame Cumming and the unlikely figure of Ben Affleck, if you like, but the circumcision debate has suddenly caught the attention of a new breed of quietly militant pro-choicers and so-called “intactivists” who are putting foreskins to the fore again and unleashing some appropriately cutting comments from the high-minded and famous.

Men with foreskins squirm and buttock-clench comedically when the subject is broached, while men who were cut as babies can’t see what all the fuss is about. Foreskins are said to heighten sexual pleasure but harbour disease. Circumcised men are said to suffer from, wait for it, “significant penile sensory deficit”, although – get this – a Men’s Health magazine survey in 2000 suggested that uncircumcised men lasted an average of four minutes longer during sex than their circumcised peers.

Pressure groups such as Brothers United for Future Foreskins (Buff) and Uncircumcising Information and Resources Center (Uncirc), and even Jews Against Circumcision, fronted by Rabbi Moses Maimonides [? ], do their best to break with tradition and prevent unnecessary cuts in the United States, while Cumming and the art critic Brian Sewell are both spokesmen for the British branch of the National Organization of Restoring Men (Norm, originally known as Recover a Penis, or Recap), founded in 1989 for men hoping to restore their foreskins. Foreskin restoration? It can be done. Sort of.

Medical techniques are not sufficiently advanced to give back the erogenous tissue and nerves amputated at circumcision, but careful stretching can create a more natural-looking penis, and softening the epithelium (or outer tissue) of the glans (or tip) can return the penis to a much higher level of sensitivity.

The pro-choicers feel that they are on a roll right now. Non-medical circumcision for children is now illegal in Sweden. The numbers of circumcision procedures in the UK are slowly declining and, after peaking in the 1930s, when 35% of British boys were snipped, fell to a mere 6.5% in the 1980s. Today, only 12,200 circumcisions are performed in the UK annually. Most of them go ahead without a hitch. A few end in tragedy.

The inquest into the death of Amitai Moshe, who was just seven days old when he stopped breathing after being circumcised at a synagogue in north London last February – he died a week later from a heart attack – is to be held tomorrow at Hornsey coroner’s court.

“No causal link has been established between the circumcision and the baby being taken ill. There is no indication that this was anything other than a tragic juxtaposition of two events,” a spokesman for the synagogue said after the child’s death. “The mohel [appointed circumciser] is a registered member of the Initiation Society, which has been licensing and training practitioners of the procedure for more than 200 years. It is a well-established and well-regulated practice.”

Anti-circumcision horror stories such as this have served only to rally the pro-choice, intactivist PR machine. As well as Affleck, who has made it known that he is against routine infant circumcision, celebrity supporters include Colin Farrell. Affleck, it should be noted, was apparently circumcised in adulthood, after suffering injury during the filming of a superhero movie; a doctor decided that removing his foreskin would be easier than repairing it. Which has to hurt.

But this isn’t just about cautiously radical telegenic celebrities or grown men checking one another out at the urinals or intact males doing histrionic winces and leg-crosses at the thought of the dreaded bris. For parents, there’s a basic guilt issue at play, too. In his eloquently incensed invective against religion, God Is Not Great, the firebrand polemicist Christopher Hitchens rails against parents who have their boys circumcised.

“As to immoral practice,” he writes, “it is hard to imagine anything more grotesque than the mutilation of an infant’s genitalia.” He argues that circumcision weakens the faculty of sexual excitement and diminishes its pleasure, pointing out the significance of the operation being performed on babies rather than those who have reached the age of reason. (One study found that 92% of male infants subject to circumcision were not given anaesthetic during the procedure.)

Unconcerned that militant Jewish factions rancorously dismiss the intactivist lobby as wholly antisemitic, Hitchens states that, as recently as 2005, a mohel in New York City quite legally performed a ritual known as metzitzah (taking a mouthful of wine and then sucking the blood from the circumcision wound) on newborn babies, giving genital herpes to several small boys and causing the death of at least two.

And what happens to all those lopped-off foreskins? Believe it or not, there is a handsome profit to be made from harvested bits of young penis. The Norm UK website features the following item: “Since the 1980s, private hospitals have been involved in the business of supplying discarded foreskins to private bio-research laboratories and pharmaceutical companies, who require human flesh as raw research material. Human foreskins are in great demand for commercial enterprises, and the marketing of purloined baby foreskins is a multimillion-dollar-a-year industry.”

There is even an expensive face cream, SkinMedica, on the market, made from a formula grown from young foreskins. Yes. Really.

“There’s a sinister side to all this,” Cumming says. “It’s tradition, control and pleasure-removing masquerading as a hygiene thing. What it comes down to is mass genital mutilation. It’s barbaric. I don’t mean to offend anyone, but I’ve heard about men who can’t orgasm for ages because they have no sensation. People in America are impeded, because they don’t feel, you know?”

There have been a number of studies conducted to find out whether male circumcision reduces the risk of acquiring sexually transmitted diseases, including HIV/Aids. While some of them show it may reduce the risk, they are not entirely conclusive, and using a condom still offers the best protection.

For Cumming, it’s more of an emotive issue. “As far as I am concerned, the default-setting arguments about hygiene just don’t stand up,” he says. “The sanitation issue, especially, always comes up when I am in America. But you know what? I am very clean. I shower frequently.

“I am very proud of my foreskin. I believe it’s there for a purpose. And I just want people to stop and think for a second before they decide to get a big bit of their newborn son’s cock cut off.”

Uganda: Don't Impose Circumcision On Natives!

OPINION
Franklin Okot

So interesting and laughable, I first dismissed it as Mickey Mouse. Never did I expect circumcision to become a national policy, leave alone an 'international arsenal' in the war against HIV/Aids. Modern scientific research risks losing relevance through half-measures and conflicting theories.

It's now part and parcel of President Bush's politics and weapons of mass deception. Instead of focusing on a cure, authorities are tagging African men to undergo rituals once reserved for Muslims and few ethnicities after "rediscovering circumcision." It's obvious, nothing short of a cure will only lead to the proliferation of HIV.

But why get rid of the virus now when there's so much money to be made? I'm blowing the whistle on this mundane conspiracy theory as Uganda, my country of birth, considered as having a "rosy" Aids record qualifies for President Bush's $15b anti-Aids fund to make circumcision readily available.

... In what's reminiscent of The River Between, neighbouring Kenya has jumped in with such zeal that uncircumcised students were barred from school.

Like Uganda, scavenging politicians competing for American patronage are in the final stages of developing a circumcision policy. I'm warning against the imposition of a tradition many consider alien.

To the Acholi and other Nilotic groups, circumcision arouses bitter resentment and reminds them of slavery, ethnic cleansing and forced Islamisation. ...

People like Dr Elioda Tumwesigye, chairman of the "prostituted" parliamentary committee on HIV/Aids, who's supposed to know better, are tagging even small children. Is he aware that even advanced countries like Canada are backtracking on what was once compulsory at birth, to give infants freedom to decide as adults? Child Circumcision is a form of child-abuse, much like Female Genital Mutilation as research has proved that newborns suffer more pain than adults.

Soon ignoramuses will be jumping up and down with euphoria: "They're now immune to HIV because they've shed blood. Gullible ones who believe that the latter have an edge over the uncircumcised, beware: Circumcision isn't worth the pain. After visiting Uganda in 2003, I too fell into circumcision mindset and decided to defy tradition.

Back in Toronto, I approached my doctor who stopped me in my tracks: Circumcision doesn't increase sensation; quite the opposite. The myth that the low rate of HIV/Aids infection and death in the Islamic world is due to circumcision is beyond naiveté. Are the Bagisu, the Kikuyu, and homosexuals faring any better? It's Islamic austerity and discipline. While others have stood up bravely in the clash of cultures, Western lifestyles ride roughshod over our cultures and traditions.

...
Whatever its merits, circumcision alone, without tackling corruption of the mind, body and soul, is a roadmap to more trouble. The new "discovery" is a tsunami that will spread, not counter HIV/Aids. It will also roll back Museveni's "rosy record" on HIV/Aids, as simple-minded Africans will throw caution to the wind.

And with no medical indications, what is infant circumcision but cosmetic?

"Further, a popular Australian young girls’ magazine recently published results of its survey of 4000 girls aged 11 to 18. "A quarter of these young women reported they would get plastic surgery if they could, and two percent had already done so,'' she told Parliament.

"Anecdotal evidence suggests that this worrying trend is a response by children and young people to the pressures they are feeling to look perfect in an increasingly competitive world that is obsessed with beauty and celebrity.

"This is very worrying. Any surgery carries a degree of risk.

"As well there are obvious risks especially with breast enhancement surgery like; detection of breast cancer becoming more difficult, infection, further corrective surgery, scarring, and even an inability to breast feed later in life.

"One Gold Coast cosmetic surgeon is reported saying she treats more than 100 teenagers a year and that the number is rising 5% a year. "This reported increase is consistent with similar reported cosmetic-practice increases for teenagers in Sydney and Melbourne.

She said her government had today released a Discussion Paper on a range of issues relating to the non-therapeutic use of cosmetic surgery by children and young people under 18 years of age.

"Cosmetic procedures in the Discussion Paper do not include the range of plastic and reconstructive surgery undertaken on children and young people under 18 years of age for therapeutic purposes.

"That is, to correct deformities, or address particular physical features that impact on their medical, psychological or social well-being.

"Discussion about the appropriateness of cosmetic procedures for young people under 18 years of age is limited to procedures that are undertaken on otherwise healthy adolescents for non-therapeutic purposes.

The Discussion Paper also includes the use of a solariums for cosmetic tanning purposes.

The issue has been the subject of recent national media attention given the death of 26-year-old Claire Oliver who died after developing melanoma, allegedly caused by using a solarium.

Currently, no Australian state or territory directly regulates the provision of cosmetic surgery to minors, or solaria use by minors.

The discussion paper entitled “Have Your Say: Children and Young People Using Cosmetic Surgery and Solarium in Queensland” is available electronically here or by emailing Queensland Health at: cosmeticsurgery@health.qld.gov.au

Epicel(TM) Wins Marketing Approval for Severe Burn Victims

First FDA-Approved Xenotransplantation Device

PR Newswire
October 29, 2007: 09:31 AM EST

CAMBRIDGE, Mass., Oct. 29 /PRNewswire-FirstCall/ -- Genzyme Corporation announced today that the U.S. Food and Drug Administration (FDA) has granted Epicel(TM) (cultured epidermal autografts) marketing approval under the Humanitarian Device Exemption (HDE) for the treatment of life-threatening wounds resulting from severe burns. It is a product that can provide permanent skin replacement for burn victims, and is made from a patient's own skin cells and then grown on a layer of mouse cells to enhance growth. Epicel is the first xenotransplantation-classified [transplanation from another species; xeno- = foreign] product to be approved in the U.S. because of its inclusion of animal cells.

"We are pleased that the FDA has recognized the importance of Epicel for patients with severe burns," said Alicia Secor, vice president and general manager of the Biosurgical Specialties group within Genzyme that manufactures Epicel. "Epicel has played a critical role in the recovery process of hundreds of patients who have suffered through the trauma of life-threatening burns."

Epicel has been used in more than 1,000 patients with burn injuries since it was introduced in 1988. The product had been considered a banked human tissue until 1996 when FDA announced that manipulated autologous [from the same person] cell-based products used for structural repair or reconstruction required regulatory oversight. Genzyme applied for regulatory approval of Epicel in 1999.

Epicel is supplied in grafts, which each consist of a sheet of cultured epidermal cells attached with stainless steel surgical clips to a backing of petrolatum gauze. Enough skin can be grown from a biopsy the size of a postage stamp to cover the entire body. The process takes approximately 16 days and the skin grafts integrate with surrounding tissue 3 to 4 weeks after surgery.

Report from South Africa

By Dean Ferris

I have just returned from the Institute
for Security Studies conference
in Pretoria, South Africa. Independent
South African intactivist
Paediatric Surgeon Dr Daniel Sidler
and myself attended. (www.
issafrica.org) We were expecting to
encounter a large contingent of
stern pro-circumcision voices. Instead
we were surprised to find
more support against the implementation
of mass circumcision in the
military!

The ISS conference was attended
by big-shots in the military
from Zambia, Zimbabwe, Lesotho,
Swaziland and South Africa. The
ISS affects policy decisions in that
policy-makers use the ISS data base
to access research (They have 2
million plus hits a month, which is
huge for a local website).

The ISS will release a summary
of the meeting and papers that were
commissioned in 6 weeks’ time.
(Editor’s Note: Presumably this is
already out.)

Although the theme of the asserted
60% protective effect of circumcision
on HIV ran though the
affair, surprisingly, this figure was
also repeatedly questioned. Regrettably,
the hypnotic trance induced
by that claim was easy to see
throughout the event. Also questioned
was the unusual push for circumcision
from UNAIDS/WHO.
The UNAIDS representative was
there and he was shocked to find
that he had walked into a storm
when he had thought a procircumcision
consensus was a foregone
conclusion.

Here are some of the concluding
remarks made by the chairmen:

Chairman 1

*Evidence is based on observations
that Western Africa has low rates of
HIV and high rates of circumcision.
Countries in the Southern Africa
Development Community (SADC)
show the opposite correlation.

*How do the armed forces react to
the claims from the three randomized
controlled trials (RCT's) suggesting
that circumcision can help
prevent HIV?

* The 60% protective effect is high
and cannot be ignored.

* If circumcision is recommended it
should not take any resources away
from other HIV programs.

*Health systems are already overextended
and are unlikely to cope
with the extra demand (especially
[if] funds are removed from existing
programs to fund circumcisions).

Chairman 2

*All policy needs to be based on
research that is long-standing and
accurate. Do we have the extraordinary
levels of proof that should be
required in order to justify action on
the WHO/UNAIDS recommendations?

*Issues of practicality, feasibility,
affordability, legality in terms of
human rights and sustainability
need to be researched and presented
before policy can be made.

* Policy can only be recommended
by the minister and state legal adviser
and ISS can only indirectly
affect such recommendations
through its publications and interactions
with the health departments.

* What effect will this suggested
policy have on human behavior?
This needs further research.

* What are the human rights implications
of forced circumcisions?

* We need cost analysis and neutral
peer reviews of all available literature
on HIV and circumcision first.

* This is an African issue and we
should not be dictated to by outside
forces.

* Time is needed and we should not
allow pressure to push us into rash
decisions.

It was noted that UNAIDS has
silenced any critics of circumcision.
The main thrust is turning out to be
a recommendation of infant circumcision,
with suggestions that it
should be done just after birth to
reduce costs. This is despite no
studies reflecting infant circumcision
can reduce HIV acquisition in
the adults they become.

However, circumcision of infants
is effectively illegal in South
Africa with the passing of the Children’s
Act number 38 2005. The
Children’s Act makes clear that circumcision
of children less than 16
years is prohibited without a
‘medical reason’. The distinction
must be made between ‘medically
indicated’ reasons and
‘prophylactic’ reasons. A medical
reason means that a condition or
disease requiring treatment is present
and requires intervention. A
prophylactic reason is to prevent a
future condition or disease that may
or may not develop. The Children's
Act thus authorizes circumcision
only for medical reasons and not
prophylactic reasons.

Unusually, WHO has endorsed a
200-page Manual of Circumcision
co-authored by pro-circumcision
researchers Daniel Halperin and
Robert Bailey.
I personally asked the UNAIDS
representative how it was
possible that this very technical
document, that looks years in the
making, could have been produced
in such a short time since the March
2007 meeting of AIDS researchers
in Montreux, Switzerland. In reply,
the UNAIDS representative admitted
that the Manual was being created
even when he joined UNAIDS [in]
July 2006, before the Lancet trials
were even published! It had in fact
been in production since 2004.

The damage of this foreskin-hostility
is already [being] felt with
parents cutting their kids and many
men already taking the plunge. I
believe this is all the procircumcison
lobby needs, a myth to be created
that will get men to start cutting
themselves.

Another major HIV vector that doesn't care if men are circumcised

Canadian Medical Association Journal 177(9)
October 23, 2007

“Homophobia is fuelling
the AIDS epidemic in Africa”

Homosexuals are a key contributor
to rising infection numbers
in many African and Middle
East countries, according to research
findings presented at a June meeting in
Rwanda of people who implement HIV
prevention and care programs.

Stigma and sex discrimination against
gays are widespread and, with the exception
of South Africa, homosexuality is
criminalized in Africa. This means homosexuals
are rarely reached by AIDS
campaigns, while lubricants they use
have often resulted in frequent breakage
of condoms, said researchers.

The annual meeting, organized by
the US President’s Emergency Plan for
AIDS Relief, was for the first time coorganized
with WHO, UNAIDS,
UNICEF and the Global Network of
People Living with HIV/AIDS.

The International Gay and Lesbian
Human Rights Commission’s Cary
Johnson said African lesbian, gay, bisexual
and transgender communities
were being decimated with a speed and
breadth reminiscent of the impact of
the epidemic on gay men in New York,
San Francisco and other North American
and European cities in the 1980s.

“Sero-prevalence rates among [homosexuals]
are higher than in the general
population.… Homophobia is fuelling
the AIDS epidemic in Africa,”
said Johnson.

Research by the Population Council at
the Kenyan tourist city of Mombasa involving
425 male sex workers revealed
that while 58% reported using a condom
during anal sex with their last male client,
only 36% consistently used condoms.

Studies by the International HIV/AIDS
Alliance showed that HIV prevalence in
the Middle East and North Africa is under
0.2% for the general population but
much higher among homosexuals. “Increased
vulnerability and poor sexual
health of [these men] is due to conservative
legal, socio-cultural and religious
contexts and limited availability of
STI/HIV services,” it stated.

High HIV rates among homosexuals
are also reported for India and Cambodia.
UNAIDS states that 25% of all people
living with HIV/AIDS in Latin America
are related to a homosexual. UNAIDS
head Peter Piot said these men, drug
users, sex workers and migrants were
among the drivers of the epidemic.
- Wairagala Wakabi, Kampala, Uganda

[The importance of this is that underreported same-sex activity is a major confounder to any effect claimed for circumcision on HIV transmission. The item speaks as if "homosexuals" in Africa are as clearly defined a group of people as in the West. (This categorisation only dates from the late 19th century and some people haven't accepted it yet.) Depending on the culture, men having sex with men may not be considered sexuality at all, but just "play" or the like. (And of course "Africa" is not uniform in that or any other respect.)]

Teams of Israeli surgeons have begun providing male circumcision in Swaziland in an effort to prevent the spread of HIV, the Washington Post reports. Health officials in Swaziland, which has fewer than 100 doctors and the world's highest HIV prevalence, say that over the next five years, they hope to offer the procedure to 200,000 sexually active men at a rate of roughly 200 daily -- 20 times faster than the current pace. According to the Post, six Israeli doctors are scheduled to work for two weeks in Swaziland this year under a program organized by the Jerusalem AIDS Project and underwritten by the U.S.-based Jewish organization Hadassah and other donors.

The Israeli doctors primarily are expected to train Swazi doctors on how to perform circumcision among adult men. However, many Swazi doctors already know how to perform the surgery. According to some Swazi doctors, what they primarily need from the Israeli doctors are "extra hands to help get enough done to impact the epidemic," the Post reports. The demand for circumcision -- especially surgeries that are no cost or subsidized -- appears to "far outstrip supply in Swaziland," according to the Post. The health system "routinely runs low" on basic medical supplies -- such as sutures, gloves, dressings and surgical tools -- the Post reports. In addition, there is a "major constraint" on surgeons and doctors, Dudu Simelane -- executive director of the Family Life Association of Swaziland, a nongovernmental group hosting the Israeli doctors -- said.

Some Swazi surgeons have shown that they can each perform 10 circumcision procedures -- which take about 25 minutes -- daily during the country's occasional series of "Circumcision Saturday" events, the Post reports. According to medical experts, it would take four doctors at each of five separate facilities to perform 1,000 circumcisions weekly if Swazi doctors can maintain that speed every weekday (Timberg, Washington Post, 10/21).

Uganda: Stick to the ABC Strategy

Dr Myers Lugemwa
Kampala

Uganda is one of the developing countries debating whether or not to adopt
circumcision as a tool to fight HIV/AIDS and other sexually transmitted
diseases (STDs).

Recent media reports have indicated an increase in the number of men going
to clinics to be circumcised. This scenario is attributed to the belief and
recent studies both in Uganda and outside, that the 'surgical attack' on the
penis could finally defeat the HIV/AIDS pandemic.

... In the [18]60s and 70s in the US,
circumcision was promoted as a way of preventing masturbation. Those opposed
to medical benefits of circumcision say that more children die from it that
the infections against which it is said to protect. it is also claimed to
reduce sexual pleasure. Others look at the practice as mutilating the
natural anatomy of God's creation.

In his book, Say No to circumcision, Dr Thomas R[i]tter writes: " the penis is
the most cherished man's physical possession. To admit that it is not, takes
a great deal of soul-searching and intellectual honesty." Marilyn Milos,
founder and director of the national organisation of circumcision
information Resource Centre, US, believes that circumcision is when sex and
violence meet for the first time in infants.

Professor Solbak's study (Oslo University) found that cancer of the cervix
in females had more to do with penile hygiene than circumcision alone.
Evidence has it that most successful rape cases are by circumcised men given
the likely trauma on the uncircumcised penis.

The causes [callers?] to circumcise in order to avoid HIV should therefore bear in mind
the fact that HIV/AIDs is very low in Europe where circumcision is rarely
practised compared to the US. Whether one is circumcised or not, what
matters is the number of sexual partners one has or whether one practise the
ABC (Abstinence, being faithful or using a condom) strategy. Since we do not
cut off our lips to keep our mouth/teeth clean, I think circumcision to keep
off the HIV should be the last resort. Take circumcision when you need it
not when you want it.

In The New Vision publication, "Men in HIV Study' of June 5, 2006, the writer
indicated that Ugandans are among men in seven countries, to get circumcised
as a measure to curb HIV infection.

The three-year study carried out by UNAIDS claims that circumcision reduces
the risk of contracting HIV by 60%. it is from this study that the debate on
adopting this method in preventing HIV infection has taken different
dimensions in the health sector. However, the researchers do not say that
circumcision does not protect women from HIV. An infected circumcised male
is just as likely to spread the disease as an uncircumcised one. The false
belief in circumcision may lead to unprotected sex practices as people may
erroneously believe that circumcision is like a condom in the ABC strategy,
which has been the cornerstone for bringing HIV prevalence rates from 34% in
the 1990s to the current 6.4%.

Circumcision was never among the factors for this reduction but rather
behavioural change, abstinence and condom use, among others. The message her
is, while circumcision may reduce the likelihood of HIV infection, it does
not eliminate it!

Look at the Xhosa tribe of South Africa who practise circumcision. If imbalu
has not protected the Gisu, what makes Uganda think that circumcision will
work here?

In 1999, the American Academy of Pediatrics reversed its position on routine
circumcision calling the practice "not essential for the child's wellbeing".

Uganda: Policy On Circumcision

THE executive director of Kigezi Health Care Foundation, Dr. Geoffrey Anguyo, has called for government policy guidelines on male circumcision.

Speaking at a meeting for Kabale district stakeholders at the council hall, he said there is need for government intervention since circumcision has been identified as an effective method of preventing one from catching HIV/AIDS.

He said research has shown that in communities where male circumcision is a must, the HIV/AIDS Prevalence is 3.7% compared to 5.5% in communities that do not carry it out. [In fact both figures vary widely from place to place.]

A research conducted by Kigezi Health Care two years ago indicates that out of 1.2 million people in Kigezi, 100,000 are living with the HIV/AIDS.

Staph Infections Deadlier Than AIDS?

Tuesday, Oct. 16, 2007 By LINDSEY TANNER/AP
(CHICAGO) — More than 90,000 Americans get potentially deadly infections each year from a drug-resistant staph "superbug," the government reported Tuesday in its first overall estimate of invasive disease caused by the germ.

Deaths tied to these infections may exceed those caused by AIDS, said one public health expert commenting on the new study. The report shows just how far one form of the staph germ has spread beyond its traditional hospital setting.

The overall incidence rate was about 32 invasive infections per 100,000 people. That's an "astounding" figure, said an editorial in Wednesday's Journal of the American Medical Association, which published the study.

Most drug-resistant staph cases are mild skin infections. But this study focused on invasive infections - those that enter the bloodstream or destroy flesh and can turn deadly.

Researchers found that only about one-quarter involved hospitalized patients. However, more than half were in the health care system - people who had recently had surgery or were on kidney dialysis, for example. Open wounds and exposure to medical equipment are major ways the bug spreads.

In recent years, the resistant germ has become more common in hospitals and it has been spreading through prisons, gyms and locker rooms, and in poor urban neighborhoods.

The new study offers the broadest look yet at the pervasiveness of the most severe infections caused by the bug, called methicillin-resistant Staphylococcus aureus, or MRSA. These bacteria can be carried by healthy people, living on their skin or in their noses.

...

The results underscore the need for better prevention measures. That includes curbing the overuse of antibiotics [and surgery] and improving hand-washing and other hygiene procedures among hospital workers, said the CDC's Dr. Scott Fridkin, a study co-author.

...

The bacteria don't respond to penicillin-related antibiotics once commonly used to treat them, partly because of overuse. They can be treated with other drugs but health officials worry that their overuse could cause the germ to become resistant to those, too.

A survey earlier this year suggested that MRSA infections, including noninvasive mild forms, affect 46 out of every 1,000 U.S. hospital and nursing home patients — or as many as 5 percent. These patients are vulnerable because of open wounds and invasive medical equipment that can help the germ spread.

Aids expert sceptical about benefits of male circumcision

Recent studies have shown no evidence that male circumcision lessened the spread of HIV, a leading expert on the disease says.

Director of the UNAIDS Regional Support Team for Asia and the Pacific, J.V.R. Prasada Rao expressed scepticism about the popular belief – which if confirmed, could help prevent the disease in men.

“Circumcision has been shown to work – there is evidence that sometimes it lessens HIV transmission. However, the practice [as a preventive measure] is dangerous to advocate because it is not 100 per cent fool-proof,” Mr Rao told Treat Asia, a journal which focuses on HIV-Aids in Asia. But many Aids researchers, like French expert Bertran Auvert, have come to the conclusion after extensive studies that male circumcision would reduce the risk of female-to-male transmission by 50 to 60 per cent. [Notice how the paper is determined to undermine the story. Male-to-female transmission, is much easier, for example.]

In 2007, the World Health Organisation and UNAIDS recommended that male circumcision be recognised as an effectual preventive measure.“Male circumcision must be recognised as an important means to fight the spread of HIV infection and the international community must mobilise to promote it,” Mr Auvert strongly emphasised at a presentation – his 2005 study involving at least 3,000 African men is believed to be one of the most extensive yet.

HIV is a virus ...

Mr Rao noted that although most Asian nations had stepped up preventive measures such as condom promotion programmes, the disease was still spreading rapidly. Transmission among vulnerable groups – sex workers, intravenous drug users (IDU) and men who have sex with men (MSM) – was particularly rapid, he said. [... and circumcision will do the latter two groups no good.]

Preventative methods only reached less than 20 per cent of these target populations especially in areas such as Thailand and Cambodia, Mr Rao added.

Different societal cultures also has to be taken into account when implementing such measures – especially predominantly Islamic states such as Malaysia as the religion traditionally prohibits birth control. [... and mandates circumcision already.]

He highlighted that a great deal of money has been spent on awareness programmes which have not created an adequate impact.

“The important part is to have political will, and also to have adequate resources for a larger scale campaign [if we are to reach at least an 80 per cent coverage].

“But there is a mismatch in the allocation of budgets. This needs to be corrected if we really want to have effective prevention strategies,” he explained.

Currently, an estimated 40 million HIV-positive patients face a major issue of costly second-line anti-retrovirals ...

Circumcision may lower syphilis risk

CIRCUMSCISION may offer gay men some protection from the sexually transmitted infection syphilis, but researchers are not recommending men get the snip.

As new figures revealed a surge in syphilis rates, a study by Sydney scientists has found that rates of the disease are higher among men who have not had the procedure.

Circumcision did not appear to offer any protection from other sexually transmitted infections like HIV, gonorrhoea, chlamydia or genital warts.

Researchers at the University of New South Wales tracked 1427 homosexual men, two-thirds of whom had been circumcised, over three years with regular testing for infections.

They found no association between infection and circumcision status for any disease except syphilis, they told the Australasian Sexual Health Conference on the Gold Coast today.

Professor Andrew Grulich from the National Centre in HIV Epidemiology and Clinical Research said the reasons for this were still unclear but it may be that the foreskin is particularly susceptible to this virus.

"We also believe that quite a bit of syphilis, up to a third, is being transmitted through oral sex in Australia at the moment," Prof Grulich said.

"If the transmission of the organism is from the mouth then this is something that is different from other infections."

Research released at the same conference this week showed syphilis numbers climbed by a third between 2004 and 2006, when 815 new infections were reported. While numbers are still relatively small, epidemiologists say the rapid rise constitutes an emerging epidemic.

But despite the surge, the results were not strong enough to recommend circumcision for those at risk, the researchers said.
"Any intervention like circumcision could only be partially effective so on the basis of this research I wouldn't be out there advocating it," Prof Grulich said.

"We wouldn't want people who are circumcised wrongly thinking that they're safe from it."

Mother seeks girl's hysterectomy

The mother of a severely disabled teenager has asked doctors to give her daughter a hysterectomy to stop her from starting menstruation.

Alison Thorpe, 45, from Essex, says 15-year-old Katie, who has cerebral palsy, would be confused by periods and they would cause her indignity.

Doctors are now seeking legal approval before carrying out the surgery.

The disabled charity Scope said the operation would set a "disturbing" precedent for other disabled girls.

If approved, it will be the first time in the UK a hysterectomy is carried out without it being medically needed.

Best possible life

Katie's mother said the operation would stop her daughter from going through unnecessary suffering.

Mrs Thorpe said: "All we are trying to do is keep and improve Katie's quality of life.

"By stopping menstruation it's allowing Katie to enjoy life to the full without the problems of menstruation...the mood swings, the tears, the stomach cramps, the pain, the discomfort, the embarrassment."

Mrs Thorpe said her daughter would not be able to ask for help or even let people know what she was feeling.

She said the decision had not been made lightly, but was something she had thought through for many years and finally decided upon when Katie turned 13.

According to the Sunday Times, Phil Robarts, a consultant gynaecologist at Mrs Thorpe's local hospital, supports her decision.

Mrs Thorpe said: "She's not going to get married and she's not going to have children...Katie is not going to become a normal adult.

"I absolutely understand that it's not for everyone, and I'm not saying it should be either.

...

'Disturbing' consequences

The disabled charity Scope reacted with alarm to the news, which echoes the case of Ashley X, a nine-year-old American girl with the mental age of a three-month-old baby [whose parents wanted her to be prevented from growing.].

The charity's executive director, Andy Rickell, said the operation could have "disturbing" implications for other disabled children, and may not even be in the best interests of Katie.

He said he acknowledged that Katie and her mother faced a difficult and sensitive situation, and that he recognised the challenges faced by families with disabled children.

But he said there were deep ethical problems with carrying out unnecessary surgery on people who are unable to give consent.

He said: "It is very difficult to see how this kind of invasive surgery, which is not medically necessary and which will be very painful and traumatic, can be in Katie's best interests.

"This case raises fundamental ethical issues about the way our society treats disabled people and the respect we have for disabled people's human and reproductive rights.

...

Simone Aspis, of the UK's Disabled People's Council, said the case was about Katie's human rights.

She said: "It is very clear to us that no operation should be undertaken if there is absolutely no clinical benefit to the person concerned.

Scans show physicians turn off empathy signal in brain to cope with pain
patients experience

By William Harms
News Office

Physicians apparently learn to "shut off" the portion of their brain, which
helps them appreciate the pain their patients experience while treating
them, and instead activate a portion of the brain connected with controlling
emotions, according to new research in neuroscience using brain scans.

Because doctors sometimes have to inflict pain on their patients as part of
the healing process, they also must develop the ability to not be distracted
or overwhelmed by the suffering, said Jean Decety, Professor in Psychology
and co-author of "Expertise Modulates the Perception of Pain in Others,"
published in the Tuesday, Oct. 9 issue of Current Biology and currently
available online.

"They have learned through their training and practice to keep a detached
perspective; without such a mechanism, performing their practice could be
overwhelming or distressing, and as a consequence impair their ability to be
of assistance to their patients" said Decety, who conducted the study with
Yawei Cheng of the Institute of Neuroscience, National Yang-Ming University
in Taipei, and other colleagues there.

Previous research, including work from Decety's lab, has shown that the
neural circuit that registers pain is activated if a person sees another
person in pain. The response in this circuit, which includes the anterior
insula, periaqueducal gray and anterior cingulate cortex, is automatic and
may reflect a panic response developed evolutionally as a means of avoiding
danger.

The research by Decety and the Taiwanese team shows for the first time that
people can learn to control that automatic response.

The team performed its research in Taiwan with two groups of evenly matched
men and women with a mean age of 35 and similar socio-economic and
educational levels-a group of 14 physicians and 14 people with no experience
in acupuncture. They were tested using a functional MRI.

Brain responses were recorded as individuals from the two groups looked at
short videotape clips in which people were pricked with acupuncture needles
in their mouth regions, hands and feet. They also watched as the patients
were touched with Q-tips. The images appeared in random order.

Among the control group, the scan showed that the pain circuit, which is
composed of the somatosensory cortex, anterior insula, periaqueducal gray
and the anterior cigulate cortex, was activated when members of that group
saw someone touched with a needle but not activated when the person was
touched with a Q-tip.

Physicians registered no increase in activity in the portion of the brain
related to pain, whether they saw an image of someone stuck with a needle or
touched with a Q-tip. However, the physicians, unlike the control group, did
register an increase in activity in the frontal areas of the brain-the
medial and superior prefrontal cortices and the right tempororparietal
junction. That is the neural circuit that is related to emotion regulation
and cognitive control.

They also asked the two groups to rate the level of pain they felt people
were experiencing while being pricked with needles. The control group rated
the pain at about 7 points on a 10-point scale, while the physicians said
the pain was probably at 3 points on that scale.

Those findings reflected the prediction the scholars had going into the
study.

"It would not be adaptive if this automatic sharing mechanism for pain was
not modulated by cognitive control. Think, for instance, of the situations
that surgeons, dentists and nurses face in their everyday professional
practices. Without some regulatory mechanism, it is very likely that medical
practitioners would experience personal distress and anxiety that would
interfere with their ability to heal," the researchers write.

For Decety, this new study also casts light on the neurological mechanisms
involved in empathy and empathic concern. The former relies on our capacity
to share emotions and feelings with others. If there is too much of an
overlap between others and self, such an overlap (reflected by similar
neural circuits that automatically and unconsciously resonate between self
and other) it could lead to personal distress, which is an aversive
reaction. Empathic concern necessitates regulating this implicit sharing
mechanism and as a consequence frees up processing capacity to act for the
sake of the other.

OUCH OUCH OUCHOUCH OUCH!

A Day at the Circumcision Palace

PHOTOS BY MAURO D'AGATI

This boy is Ali. This picture was taken as he was being circumcised in the operating room of the Kemal Özkan Circumcision Palace. The two-story building includes a playground with a go-kart track, a dancing hall, and a restaurant.

In Islamic Turkey, circumcision is much more than a surgical procedure. Traditionally occurring between the ages of five and 12, and known as the “first joy,” it’s seen as the first landmark in the boy’s religious life, proof that he is strong, brave, and ready to be called a man. To this end, the procedure is generally performed with local anesthetic or none at all, as the pain is an integral part of the ritual.

A White Wedding

Roger Sandall
Can it be true? Did a woman anthropologist actually compare the
ceremony at which young Masai girls are genitally mutilated to "a
white wedding"?

Yes she did. It's true. The anthropologist's name is (or was) Melissa
Llewellyn-Davies MFA. ... Ms Llewellyn-Davies compared genital mutilation to a white wedding in her
chillingly misleading narration for the film Masai Women, a Disappearing World production. You can buy it today from CD Universe for $13.49. ...

Elder cuts penis in tribal ceremony

The 50-year-old tribal elder has been charged with unlawful wounding
following Thursday's incident in a Perth park.

The 23-year-old victim haemorrhaged, losing almost half a litre of blood
following the ritual, said police spokesman Ian Hasleby.

The younger man had asked the Kimberley elder to perform the
ceremony.

"Both men travelled by bus to Bayswater around 7.30pm (WST) and in a park
on Coode Street the alleged offender used a razor blade and twice cut the
victim's penis, causing a heavy loss of blood," Mr Hasleby said.

The victim hailed railway guards who called an ambulance.

Doctors estimated he lost almost half a litre of blood, Mr Hasleby said.

The tribal elder will face Perth Magistrates Court next Wednesday.

[If a man can be charged with unlawful wounding when he does what he is asked to by the victim, what should he be charged with when the victim is a newborn baby?]

Jewish "intactivists" in U.S. stop circumcising

NEW YORK (Reuters) - In most respects, Michelle Chernikoff Anderson is a rabbi's dream congregant. She sings in the choir and takes classes at her synagogue.

But, like an increasing number of Jews in the United States, she has decided not to circumcise her son, rejecting the traditional notion that it is a Biblically prescribed sign of the Jewish relationship with God.

"I see circumcision as a blood ritual that I can let go of," said Anderson, who lives in Southern California.

...

"Circumcision's out of the closet. It's not a taboo subject anymore. People are talking about it. Parents are talking about it," said Dr. Mark Reiss, a synagogue-goer in the San Francisco area and executive vice president of Doctors Opposing Circumcision.

Among those talking about it is a gaggle of young, male, Jewish commentators. This year alone, in books, online and in magazines, authors Neal Pollack, Sam Apple, Jonathan Safran Foer and Shalom Auslander have all fretted about doing to their sons what was done to them. The title of Auslander's memoir, scheduled for publication in October, is "Foreskin's Lament."

Circumcision is even before the courts. In November, the Oregon Supreme Court will rule on whether a convert to Judaism can force his 12-year-old son to undergo the procedure.

"INTACTIVIST"

Reiss, who calls himself an "intactivist," maintains a roster of 50 officiants who conduct nonsurgical alternatives to the bris, traditionally performed on the eighth day after a boy's birth. He says he fields as many as five queries weekly from conflicted parents.

...

Michael Young, a convert to Islam, had his infant son circumcised but did not undergo the procedure himself. "I'm very squeamish and hate the thought of it," he said. [His son probably does, too.]

...

But author Julius Lester, who became a Reform convert to Judaism in 1982 and underwent circumcision to feel Jewish, said the procedure also boosted his sex life.

"Circumcised there are far more subtle sensations, and staying power is much, much longer," he said [Many say the reverse.]. "From a sexual point of view, I wish I'd gotten circumcised many years earlier." [He had the choice and he took it.]